Abuse, Aggression, Violence Lecture Review

Flashcards covering Abuse, Aggression, and Violence, including definitions, risk factors, clinical manifestations, types of abuse, and nursing interventions and roles.

Abuse

Systematic strategies used to obtain dominance and control over others, including psychological, physical, emotional, economic, and sexual forms.

Physical Abuse

Perpetrators use force like kicking, hitting, strangling to control behavior. Signs include bruising, lacerations, burn marks, and fractured bones.

Emotional Abuse

The use of threats, insults, and intimidation to exert control. Signs can include social withdrawal, loss of self-esteem, and anxiety.

Sexual Abuse

Any forced, inappropriate, or unwanted sexual contact, including unwanted touching, rape, or coerced nudity.

Neglect and Abandonment

Failure to provide necessary care or desertion of a vulnerable individual. Signs include untreated health problems, poor hygiene, hazardous living conditions, and claims of being mistreated.

Financial Abuse

Misuse of another person’s financial resources, with or without permission. Signs include unexplained withdrawals, abrupt changes in wills, or reports of exploitation.

Anger

An intense emotion with both positive and negative effects; unrestrained, it can lead to physical and emotional harm but is not often followed by an aggressive act.

Aggression

Actions intended to harm, which can be either physical, psychological, or both.

Risk Factors for Abuse, Aggression, Violence

Includes a history of violence, mental health disorders (including substance use), being a victim or witness of violence, poor self-esteem, inadequate coping skills, lack of positive role models, and adverse childhood experiences (ACEs).

Etiology of Aggression

Can include genetic factors (e.g., MAO gene deficit), social determinants, and medical conditions like damage to brain regions (prefrontal cortex, limbic system, amygdala), Alzheimer's, and addictive personalities.

Defense Mechanisms of Perpetrators

Strategies used to shield from disagreeable thoughts, such as displacement (redirecting anger) and undoing (making amends after abuse).

Violence

The ultimate form of aggression, such as murder, rape, or other physical assault, with increased risk among individuals with substance use disorder, TBI, PTSD, Bipolar I, impulse control disorders, and ADHD.

Adverse Childhood Experiences (ACEs)

Potentially traumatic events experienced before age 18 that can affect individuals emotionally and physically later in life, including violence, abuse, neglect, or an unsafe home environment.

Bullying

Uninvited, aggressive behaviors from one youth or group to another, involving repeated actions, a perceived or actual power imbalance, and unwanted aggressive behaviors.

Intimate Partner Violence (IPV)

Physical violence, sexual violence, stalking, or psychological aggression by a current or former partner or spouse, occurring in three phases: build-up, acute battering, and honeymoon/reconciliation.

Phases of Intimate Partner Violence

Phase 1: Build-up (increased tension, arguments, minor abusive incidents). Phase 2: Acute Battering (intense rage-filled abusive acts). Phase 3: Honeymoon/Reconciliation (perpetrator becomes affectionate, apologetic, promises change, but maintains control).

Elder Abuse

Neglect, abuse, or financial exploitation of older adults, particularly those dependent on others for daily care, with cognitive impairment, physical disabilities, or limited social support.

Rape and Sexual Assault

Rape involves forced sexual intercourse (physical or psychological coercion), while sexual assault involves unwanted sexual contact without penetration (e.g., verbal threats, fondling).

Stalking

Unwanted attention, threats, or harassment, often by individuals known to the target, involving following, watching, unauthorized entry, or nuisance communication.

Implicit Bias

Unconscious discriminatory attitudes that can trigger negative reactions or fear, leading to disparities in care, especially for ethnic, racial, and minority groups, and stereotyping based on past experiences.

Client-Centered Care in Aggression

Developing a therapeutic, culturally relevant relationship, viewing illness from the client's perspective, and recognizing that aggression can signify distress or unmet needs.

Managing Agitation

Strategies include removing the client from annoying stimuli, allowing space and time, asking what can be done, responding calmly, and maintaining situational awareness (e.g., not blocking exits).

Forensic Nurse

A registered or advanced practice nurse with additional education specific to violence or victimization, working with survivors, assisting with investigations, and providing expert testimony.

Sexual Assault Nurse Examiner (SANE)

A registered nurse with advanced education in forensic examination of sexual assault survivors, conducting focused genital exams, preserving evidence, administering medications, and providing expert testimony.

De-escalation

A non-pharmacologic intervention strategy to calm agitated clients, involving respecting personal space, establishing verbal contact, giving simple directions, identifying wants and feelings, setting limits, and offering choices.

Seclusion and Restraints

Interventions used only when less restrictive measures fail to mitigate danger to self or others, initiated with a prescription, not for punitive reasons, and requiring ongoing assessment and documentation.

Pharmacologic Interventions for Aggression

Long-term control uses antipsychotics, mood stabilizers, anticonvulsants, and antidepressants. Acute aggression may involve IM injections like 'B52' (diphenhydramine, haloperidol, lorazepam) or other sedatives.

Self-Injury Behaviors (NSSH)

Intentional harming of self as a coping mechanism, including cutting, scratching, biting, burning, hair-pulling, and head-banging, without suicidal intent but a strong predictor of future suicide attempts.

NSSH Risk Factors

Include ACEs, poverty, abuse/neglect, unresolved family issues, onset in adolescence, school pressures, body image issues, and associated mental health disorders like eating disorders or borderline personality disorder.

NSSH Warning Signs

Unexplained scars, fresh cuts/burns, excessive skin rubbing, hidden sharp objects, excessive covering of limbs, poor interpersonal relationships, identity issues, unpredictable emotions, and feelings of worthlessness/hopelessness.

NSSH Interventions

Reaching out to trusted confidantes, exploring creative expression (coloring, journaling), re-centering thoughts, developing action plans, educating clients and significant others, and establishing support systems.